Pediatric Gastroenterology, Faculty of Medicine, Adıyaman University, Adiyaman, Turkey.
Pediatrics, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey.
Int J Clin Pract. 2021 Nov;75(11):e14679. doi: 10.1111/ijcp.14679. Epub 2021 Aug 13.
The non-classic presentation of paediatric celiac disease (CeD) becomes increasingly common in daily practice, which requires an awareness of eye findings. The purpose of this study was to evaluate eye involvement and effect of gluten-free diet on ocular involvement in paediatric CeD patients by measuring the thicknesses of choroid and ganglion cell complex (GCC) composed of retinal nerve fibre layer, ganglion cell layer and inner plexiform layer using enhanced depth imaging optical coherence tomography.
Forty-three CeD patients aged between four and 16 years (mean age: 9.9 ± 4.1, 12 boys and 31 girls) and 48 healthy children (mean age: 11.3 ± 4.1,17 boys and 31 girls) were compared. Following comprehensive eye examinations, thicknesses of choroid at three points and GCC layers (retinal nerve fibre layer at five points, ganglion cell layer and inner plexiform layer) were obtained using enhanced depth imaging optical coherence tomography. Measurement of thicknesses of choroid and GCC layers by a trained optical coherence tomography technician and an ophthalmologist who were not aware about group of children in paediatric CeD patients with 1 year gluten-free diet was carried out.
All layers of subfoveal, nasal and temporal choroid were significantly thinner in CeD than in the control group (P < .001, all, respectively). No significant difference was observed between the CeD and control groups in terms of GCC thicknesses (P > .05, all, respectively).
Paediatric CeD caused thinning of subfoveal, nasal and temporal areas of choroid, and this change is apparent even after 1 year gluten-free diet. This eye involvement should be more closely screened at diagnosis, and long-term clinical results of thin choroid should be determined. Thicknesses of GCC layers were not different in CeD group and may reveal the effect of diet or not involvement.
儿科乳糜泻（CeD）的非典型表现在日常实践中越来越常见，这需要对眼部表现有一定认识。本研究旨在通过测量脉络膜和节细胞复合体（GCC）的厚度来评估眼部受累情况，并评估无麸质饮食对儿科 CeD 患者眼部受累的影响，该复合体由视网膜神经纤维层、节细胞层和内丛状层组成，使用增强深度成像光相干断层扫描。
比较了 43 名年龄在 4 至 16 岁之间（平均年龄：9.9 ± 4.1，12 名男孩和 31 名女孩）的 CeD 患者和 48 名健康儿童（平均年龄：11.3 ± 4.1，17 名男孩和 31 名女孩）。在进行全面的眼部检查后，使用增强深度成像光相干断层扫描获得脉络膜三个点和 GCC 层（视网膜神经纤维层 5 个点、节细胞层和内丛状层）的厚度。由一名经过培训的光相干断层扫描技术员和一名对儿童分组不知情的眼科医生测量 CeD 患儿接受 1 年无麸质饮食治疗前后脉络膜和 GCC 层的厚度。
CeD 组的所有黄斑下、鼻侧和颞侧脉络膜层均明显薄于对照组（P <.001，分别）。CeD 组和对照组之间在 GCC 厚度方面没有显著差异（P >.05，分别）。
儿科 CeD 导致黄斑下、鼻侧和颞侧脉络膜区域变薄，即使在 1 年无麸质饮食治疗后，这种变化也很明显。这种眼部受累情况应在诊断时更密切地进行筛查，并确定薄脉络膜的长期临床结果。CeD 组的 GCC 层厚度无差异，可能显示饮食的影响或无受累。
